Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07365 | Date 21/10/2022 |
| Token No | SM/22-23/5751 22/10/2022 | Serial | 003 |
| Patient Name | Mrs. JYOTSNA BHATTACHARJEE | Contact No | 9051612198 |
| Address | 82 THAKUR BATI STREET | Age | 43 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||